Although there are competing alternatives available to treat benign prostatic hyperplasia (BPH), transurethral resection of the prostate (TURP) remains the gold standard using either general or spinal anesthesia. There are advantages and disadvantages related to spinal or general anesthesia. Anesthetic concerns and complications during the preoperative, intraoperative, and postoperative surgical phases are analyzed and summarized. Early detection and prevention play a key role in reducing complications and shortening the recovery period.